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Testing Report for 2017-04-19-14-4

Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.

Project Information

DEA: 072159U4
EFIS: 0715000160
Project ID: 211260
QA Service Level: 1
DIST-CO-RTE-PM: 07-LA,ORA-5-0.0/1.5, 44.3/44.4
Work Description: CONSTRUCT HOV LANES AND MIX FLOW LANES.
Location Description: LOS ANGELES AND ORANGE COUNTIES IN BUENA PARK, LA MIRADA, CERRITOS AND SANTA FE SPRINGS FROM ARTESIA BOULEVARD UNDERCROSSING TO NORTH FORK COYOTE CREEK
Contractor Name: Unknown
Contractor Address: Unknown
Resident Engineer: George Saker
Structure Rep.: Danny Lalonde

Sample Information

DIME Sample ID: 2017-04-19-14
TL Number from the TL Form: Unknown
Sample Submitted By Organization: G3 Quality, Inc. - Cerritos
Sample Organization Contact: (562) 321-9840
Type of Sample: Quality Control
Type of Material: Aggregate
Sample Taken Date: 4/19/2017
Date that the sample was received by the laboratory/organization performing the testing: 4/20/2017
The quantity of what the sample constitutes: 1 Bag
A brief description of the sample: Rock and Sand
From where was the sample collected: Source
Laboratory sample identification: Mix HRC14058
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Holliday Rock

Material Information

Source Identification (SMARA or name of Pit): 91-19-0025::IRWINDALE
The fabricator's/manufacturer's product name for the sample: Set 1
The fabricator/manufacturer designation for the sample: Unknown
The plant number: Unknown
A detailed description of where the material sample was collected: Unknown
Where the material sample would have been placed if not sampled: Unknown
Primary Aggregate Nominal Size: 1 inch
The concrete mix design number: HRC14058
Lot number:
Sublot number:

Test Information

DIME Test ID: 2017-04-19-14-4
Test Method: CTM 226-July 2010: Method for Moisture Content of Soils and Aggregates by Oven Drying
Date Tested: 4/20/2017
Verified Date: 7/21/2017
Submitted By Organization: G3 Quality, Inc. - Cerritos
Organization Address: 13850 Cerritos Corporate Drive, Unit E,
Organization City: Cerritos
Organization State: CA
Organization Zipcode: 90703
Organization Email: hwalker@g3quality.com
Organization Phone: (562) 321-9840
General Comments for this Test:
Test Result Compliance:
Additional Comments When Verified :

Submitted Test Results

No reportable test results have been submitted for this test.